Accountable Care: Defining the Future of Healthcare Reform

In an ongoing effort to reduce adverse events, the Obama Administration is expected to announce the National Patient Safety Initiative that will paint a more detailed panorama of the future landscape of healthcare reform. Rather than introducing new standards, the initiative will heavily promote proven strategies. The foundation of this initiative is expected to rest soundly on accountable care.

By 2015, nearly 10% of all Medicare reimbursements to hospitals will be tied to public reporting of errors and to meeting standards of delivering high quality patient care. Reaching beyond the borders of Medicare, Obama is calling for private insurers to do the same.

The initiative is expected to focus sharply on limiting hospital-acquired infections and avoiding preventable hospital readmissions. These two issues cost an estimated $50 billion a year in Medicare reimbursements.

A Partnership for Quality

The initiative is tied closely to the Obama administration’s public-private partnership to improve the quality, safety, and affordability of healthcare and unveils a reimbursement structure that rewards providers for high-quality care. It also gives these providers the tools they need to implement best practices.

The cornerstones of the initiative include:

  • Help for healthcare organizations to rapidly improve patient safety—The recently formed CMS Innovation Center will test mechanisms that will make information about effective practices and new knowledge on patient safety widely available. The Innovation Center will also seek support from hospital administrators and governing boards to make patient safety a priority. 
  • Collaborative networks—The CMS Innovation Center will lend support to facilitate the development of networked learning projects among states and large healthcare systems that will achieve targeted performance levels. Networks that achieve these targets will receive additional support for expanded work. 
  • Payment alignment between public and private sectors—The CMS will be implementing a dramatic transformation in how Medicare pays for care. Medicare payments to hospitals will increasingly be tied to performance. Also, the CMS will investigate partnerships with states and the private sector to achieve similar reforms in Medicaid and private health insurance.
  • Rewards for high-performing hospitals—The CMS will establish a national recognition program for hospitals that achieve quality goals. Hospitals that receive such recognition can expect to have a significant competitive advantage over those that don’t.
  • Standardized measures—Resources will be funneled into developing improved measures of patient safety so private and public methods of measuring patient harm can be standardized. These measures will be used as the benchmarks in determining Medicare reimbursement to hospitals.
  • Improved patient engagement—The CMS Innovation Center will test and promote effective models of patient engagement and disseminate these strategies among large national employers, consumer organizations, health plans, and hospitals as well as state and federal governments. Strategies will include tools and resources for patients and family members with the expectation of driving demand for patient safety improvements.
  • Improved accountability and oversight—Revisions to the Medicare Conditions of Participation will likely focus on patient safety and quality improvement along with an expanded role for quality improvement organizations in assessing and supporting hospital improvements. 

Add a comment:

Your email address will not be published. Required fields are marked *